Inability of polyglycolic acid mesh to inhibit immediate post-radical pelvic surgery adhesions

Abstract

The ability of a polyglycolic acid (PGA)-derived mesh to limit the formation of immediate postoperative pelvic adhesions after radical resection of the pelvic viscera and peritoneum was investigated. Twenty female canines underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and infracolonic omentectomy. The entire peritoneum of the pelvis and lower abdomen also was removed. In ten animals, a single layer of PGA mesh, tailored to cover the deperitonealized area, was sutured in place. Reperitonealization was not performed in control animals. Four weeks after initial surgery, animals were reexplored and killed. Adhesions to the anterior abdominal wall and pelvis were quantified and graded: n Anterior abdominal wall Pelvis Abscesses Mesh 10 2.93 ± 1.50 15.13 ± 15.19 4 Control 10 0.18 ± 0.26 ( P < 0.05) 2.43 ± 1.60 0 ( P < 0.05) ( P < 0.05) These data indicate that the placement of a PGA mesh induces significant pelvic adhesions and potentiates the formation of pelvic abscesses.